PTSD Prevention

In her work with soldiers returning from tours of duty in Iraq and Afghanistan, SPH
alumna Marcia Valenstein, M.D., M.S. ’97, sees the kinds of symptoms that can grow into full-blown post-traumatic stress syndrome:
sleep disturbance, hypervigilance, difficulty re-engaging in civilian life.

All of these symptoms can resolve themselves without intervention. But when returning
veterans lack solid social-support systems, or are unemployed, or experience other
at-home stressors, they’re at a heightened risk of developing PTSD—as is anyone else
who has experienced or witnessed a traumatic event, Valenstein says.

PTSD is a severe anxiety disorder that develops in some people who have been exposed
to events involving the threat of serious injury or death.

An associate professor of psychiatry at the UM Medical School and a clinician and
researcher at the Veterans Administration Ann Arbor Healthcare System, Valenstein
is working with colleagues in both institutions to develop and implement a program
to help returning National Guard soldiers reintegrate into civilian life—and avoid
PTSD.

Called Buddy-to-Buddy, the peer-based program pairs returning National Guard vets
with fellow soldiers from their returning units as well as other volunteer veterans.
These “buddies” help new vets find employment and medical care and adjust to nonmilitary
life, and they keep an eye out for trouble signs. The program is part of Welcome Back
Veterans, a national initiative aimed at easing the transition from military to civilian
life, and it’s “pure public health,” Valenstein says. “It’s all about prevention.”

Not all soldiers, of course, experience or witness traumatic events—a classic cause
of PTSD. But “simply being in danger 24/7” breeds stress, Valenstein says. In both
Iraq and Afghanistan, even soldiers in supportive roles are vulnerable to roadside
bombs and mortar attacks. “There’s no place to completely relax. If you’re in country,
you’re on edge. Eventually you exhaust yourself from being on edge all the time.”

Valenstein and her team are currently evaluating the program to see how effectively
it’s working, but she notes that Buddy-to-Buddy has already drawn interest from colleagues
in other states. She hopes it will be a model for preventing PTSD, not just among
veterans but for anyone at risk of developing the disorder.